Date posted:
Attachment(s):
The Department proposes routine technical changes to 10-144 C.M.R. Ch. 332; MaineCare Eligibility Manual to ensure compliance with Sections 1903(v)(5) and 2107(e)(1)(R) of the Social Security Act (SSA), as amended by § 71109 of the Budget Reconciliation Act of 2025 (P.L. 119-21), effective October 1, 2026.
The proposed rule will update Part 2, eliminating eligibility for some noncitizens in order to align with federal regulations cited above. Part 2, Section 5 will be updated to clarify expectations for reporting of Social Security numbers. Part 2 will also be updated to align with federal changes to 42 C.F.R. § 435.407 concerning documentation requirements for U.S. citizens and U.S. nationals. In addition, the proposed rule changes Part 6, Section I by eliminating “They are automatically eligible for Medicaid unless they refuse to assign their rights to medical payments (see Part 2, Section 6) for medical care or are ineligible due to Medicaid Qualifying Trust rules (see Appendix H).” Further, the proposed rule will make non-substantive changes to correct typographical errors, improve readability and provide clarifying language for readers, participants, and Department staff.
changes are intended to ensure compliance with Sections 1903(v)(5) and 2107(e)(1)(R) of the SSA and P.L. 119-21 § 71109 regarding those noncitizens no longer eligible for MaineCare. Proposed rule changes will ensure Department staff are able to accurately determine MaineCare eligibility for some noncitizens, based on their immigration status.
The Department considered Sections 1903(v)(5) and 2107(e)(1)(R) of the Social Security Act, 42 C.F.R. § 435.407 and the Centers for Medicare and Medicaid Services – State Health Official Letter 26-001 RE: Implementation of Section 71109 “Alien Medicaid Eligibility” of the Working Families Tax Cut Legislation (Public Law 119-21) issued April 8, 2026 during the development of this rule.
This rule results in approximately 1,023 individuals being moved into Emergency Services coverage only, based on immigration status. The anticipated savings of this rule on the MaineCare program are estimated to have a fiscal impact of ($17,825,673) in SFY2027, which includes ($11,817,273) in federal dollars and ($6,008,400) in state dollars, and in SFY2028 a total savings of ($23,767,564), which includes ($15,739,508) in federal dollars and ($8,028,056) in state dollars.
The anticipated savings of this rule on the MaineCare program are estimated to have a fiscal impact of ($17,825,673) in SFY 2027, which includes ($11,817,273) in federal dollars and ($6,008,400) in state dollars, and in SFY 2028 a total savings of ($23,767,564), which includes ($15,739,508) in federal dollars and ($8,028,056) in state dollars. While the impact cannot be determined at this time, this rule will result in increased spending of state funds for non-Medicaid funded state services and to the “free/uncompensated” care for hospitals and providers in Maine.
Beginning October 1, 2026 approximately 1,023 individuals will be moved into Emergency Services coverage only, based on their immigration status. This rule will have a fiscal impact to the “free/uncompensated” care for hospitals and to providers in Maine.
The proposed rule would update changes for some noncitizens’ eligibility criteria consistent with the Social Security Act §§ 1903(v)(5) and 2107(e)(1)(R) and P.L. 119-21 § 71109. These changes are necessary to stay in compliance with the federal Medicaid program and ensure that Maine can continue to provide this necessary coverage.
Public Hearing(s): No public hearing is scheduled.
Comment Deadline(s): Monday, September 14, 2026, at 5:00 p.m. Eastern Time. Written public comments may be submitted via the link at https://www.maine.gov/dhhs/about/rulemaking
Type of Rule: Routine Technical
Statutory Authority: 22 M.R.S. §§ 42(1), 3173, and 3174-FFF
Name, Address, Telephone Number, and Email Address of Agency Contact Person:
Adam Hooper, MaineCare Program Manager
Department of Health and Human Services, Office for Family Independence, 109 Capitol St., Augusta, ME 04333-0011
(207) 441-4916
Proposed
Office: Office for Family Independence
Routine technical
Email: Adam.Hooper@maine.gov
Comment deadline:
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The comment period for this rule has closed.